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Study of Death: Thanatology (Thanatos: Greek God of Death)

DEATH AND DYING. Study of Death: Thanatology (Thanatos: Greek God of Death) Pascal: man is the only animal that knows he will die some day Fear of death uniquely human Historically, death part of daily life, high mortality rate, took place at home 20 century: death in hospital

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Study of Death: Thanatology (Thanatos: Greek God of Death)

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  1. DEATH AND DYING • Study of Death: Thanatology • (Thanatos: Greek God of Death) • Pascal: man is the only animal that knows he will die some day • Fear of death uniquely human • Historically, death part of daily life, high mortality rate, took place at home • 20 century: • death in hospital • medical technology • facilitated death denial • funeral parlours • euphemisms

  2. About age 9-10 we realize that death is final, universal and inevitable • Adolescence: invulnerable, immortal “can’t happen to me”, risk taking, denial • Early adulthood: change when becoming parents • Middle age: death of parents, friends, siblings. Highest death anxiety • Old age: lowest anxiety, though facing death of spouse and peers • Role of religion: true believers and atheists lowest anxiety

  3. What is death? • Determined by doctor (if available). Errors • Clinical death: heart and lungs stop. But nowadays resuscitation through technology: CPR, oxygen, defibrillation, etc. (NDEs) • Brain death: no EEG. New structures (cerebral cortex) die first, then midbrain, then medulla and spinal cord (vegetative functions and reflexes): is this person alive? Coma

  4. Euthanasia: active or passive • Active: method used to terminate life, e.g. drug, asphyxia, etc. • Special case: assisted suicide (Kevorkian) • Passive: withhold or remove life support • Ethical issue: Nazis • Issue of longevity and economics • Cultural variations, Netherlands • NDE: Near death experience, increase since resuscitations increased

  5. First thanatologist: Elizabeth Kubler-Ross Process in 5 stages: • Denial • Anger • Bargaining • Depression • Acceptance • Not a typical stage process: individual differences, order of stages, return to earlier stages • Also observed in chronic illness, loss of body parts, loss of function

  6. Schneidman: alternation of emotions instead of stages: • grief • anguish • anger • anxiety • denial • NO acceptance

  7. Pattison: living-dying interval, prolonged by technology • 3 phases: • acute crisis: time of diagnosis • chronic: gradual deterioration, longest phase due to medical-technological advances • surrender: giving up, not a real acceptance • Variables that affect process: • age • cause of death • personality • religious beliefs • ethnic background • hospital, home or hospice location

  8. Survivors: • Grief: feelings • Mourning: behaviours that express grief • Rituals: e.g. Irish wake, sitting shiva • Stages: • numbness • yearning, anger and denial • depression, apathy, disorganization • acceptance, adjustment, reorganization All 4 can coexist and alternate

  9. Varying time span, influence of culture • Child and spouse worst • Widows/widowers: longer grieving if bad marriage: sanctification of dead spouse (guilt) • Increase in morbidity and mortality (one study in text contradicts) Double whammy: • immune system weakens • self neglect (meals, exercise, sleep, smoking and drinking)

  10. Psychoneuroimmunology • Psycho: thoughts and feelings • Neuro: brain and nervous system • Immuno: immune system • Logy: study of • People who have supports fare better • Anticipatory grief helps (when death is expected)

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